title: The reassuring value of diagnostic tests: a systematic review.
abstract: OBJECTIVE
  This review is a narrative synthesis of the RCTs which studied the efficacy of using diagnostic tests to reassure patients.
  
  
  METHODS
  We searched for RCTs that examined the level of reassurance after diagnostic testing in outpatients. We used PubMed, Psychinfo, Cochrane Central, Ongoing Trials Database and Scopus.
  
  
  RESULTS
  We found 5 randomized controlled trials that included 1544 patients. The trials used different diagnostic tests (ECG, radiography of lumbar spine, MR brain scan, laboratory tests, MR of lumbar spine) for different complaints (e.g. chest pain, low back pain and headache). Four out of 5 RCTs did not find a significant reassuring value of the diagnostic tests. One study reported a reassuring effect at 3 months which had disappeared after one year.
  
  
  CONCLUSIONS
  Despite the sparse and heterogeneous studies, the results point in the direction of diagnostic tests making hardly any contribution to the level of reassurance. We recommend further studies on the use of diagnostic tests and other strategies to reassure the patient.
  
  
  CONCLUSIONS
  A clear explanation and watchful waiting can make additional diagnostic testing unnecessary. If diagnostic tests are used, it is important to provide adequate pre-test information about normal test results.
authors.affiliation: Department of Primary and Community Care, Radboud University Nijmegen Medical Centre, The Netherlands; Department of Psychiatry, Radboud University Nijmegen Medical Centre, The Netherlands. Electronic address: h.vanravesteijn@elg.umcn.nl.
authors.forename: Hiske
authors.initials: H
authors.lastname: van Ravesteijn
authors.affiliation: Department of Primary and Community Care, Radboud University Nijmegen Medical Centre, The Netherlands; Department of Psychiatry, Radboud University Nijmegen Medical Centre, The Netherlands.
authors.forename: Inge
authors.initials: I
authors.lastname: van Dijk
authors.affiliation: Département d'enseignement et de recherche en médecine générale, UFR médecine, Université Nice Sophia Antipolis, France.
authors.forename: David
authors.initials: D
authors.lastname: Darmon
authors.affiliation: Department of Primary and Community Care, Radboud University Nijmegen Medical Centre, The Netherlands.
authors.forename: Floris
authors.initials: F
authors.lastname: van de Laar
authors.affiliation: Department of Primary and Community Care, Radboud University Nijmegen Medical Centre, The Netherlands.
authors.forename: Peter
authors.initials: P
authors.lastname: Lucassen
authors.affiliation: Department of Primary and Community Care, Radboud University Nijmegen Medical Centre, The Netherlands.
authors.forename: Tim
authors.initials: T
authors.lastname: Olde Hartman
authors.affiliation: Department of Primary and Community Care, Radboud University Nijmegen Medical Centre, The Netherlands.
authors.forename: Chris
authors.initials: C
authors.lastname: van Weel
authors.affiliation: Department of Psychiatry, Radboud University Nijmegen Medical Centre, The Netherlands.
authors.forename: Anne
authors.initials: A
authors.lastname: Speckens
mesh_terms: D002637:Chest Pain / Q000175:diagnosis / Q000523:psychology; D003142:Communication; D003955:Diagnostic Tests, Routine / Q000523:psychology* / Q000592:standards; D005239:Fear / Q000523:psychology*; D006261:Headache / Q000175:diagnosis / Q000523:psychology; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis / Q000523:psychology; D010353:Patient Education as Topic; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D057832:Watchful Waiting